15D0722964 CLIA NUMBER - KOSCIUSKO AMBULANCE SERVICE LLC

Laboratory Demographics

CLIA Number: 15D0722964

Facility Name: KOSCIUSKO AMBULANCE SERVICE LLC

Facility Address:
445 ANCHORAGE ROAD
WARSAW, IN
ZIP 46580
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Facility Phone Number: 574 269-1975

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1780068122

Taxonomy: 341600000X - Ambulance
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).

CLIA Record

Field Name	Field Value
CLIA Number	15D0722964
LAB Type	Ambulance
Facility Name	KOSCIUSKO AMBULANCE SERVICE LLC
Street	445 ANCHORAGE ROAD
City	WARSAW
State	IN
ZIP	46580
Phone	574 269-1975
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024